Individual
ANNE LISE SULLIVAN MUSSELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3005 GRAPE RD STE B, MISHAWAKA, IN 46545-2709
(800) 769-0045
Mailing address
3005 GRAPE RD STE B, MISHAWAKA, IN 46545-2709
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
09000480A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05330983
—
NY
Enumeration date
07/13/2017
Last updated
04/25/2025
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